| NPI | 1730475674 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MN 55254) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 55254) |
| Enumeration Date | 2011-06-20 |
| Last Update Date | 2020-08-11 |